(Extracts from
"The Health Biographies of Alexander Leeper, Robert Louis
Stevenson, And Fanny Stevenson" and "The Posture Theory
11th edition")

The ancient Greeks coined the word hypochondria
because of their assessment that the many and varied symptoms
were caused by a disorder originating beneath the cartilages
of the lower ribs, however throughout the twentieth century the
prevailing view was that the set of symptoms were related to
a fear of imaginary illnesses which produced an unwarranted and
irrational interest in health. Nevertheless in my assessment
the primary factor which generated an interest in health was
the fact that doctors were unable to provide a plausible explanation
for a persons symptoms and because the person had not achieved
a cure despite the fact that they had diligently followed medical
advice and taken the prescribed treatment for many years.

This page contains two primary quotes.
The first quote
represents the medical opinion about hypochondria which prevailed
throughout the twentieth century with some minor variations on
the general theme, and which was generated by the medical literature
and is evident from the newspaper, radio, and television portrayal
of the complaint, and which generated the common public understanding
(misconception) of the condition. This specific medical opinion
was published in London in1928, during the lifetime of Alexander
Leeper, and was widely distributed as a medical reference book
for the general public. Thirteen doctors contributed to this
book which was called "The Modern Family Doctor".

The second quote
gives an account of the actual life and achievements of Alexander
Leeper who was described as having "massive hypochondria".
He kept extensive diaries in which he recorded everything about
his life and his health.

By comparing these two quotes the extremes of the discrepancy
can be clearly seen, and are very easily found in the biographies
of other famous people such as Charles Darwin, the genius, Florence
Nightingale, the founder of modern nursing, Howard Hughes, the
American Billionaire, Napoleone, the French Emperor, and Moliere,
the French author of comedy plays.

At the end of this page I provide some other relevant quotes
which will be of interest to people who wish to study this subject.

The prevailing
account of hypochondria in the twentieth century

The stage of adolescence is the period of "man in the making"
and lasts about 10 years, during which time the higher mental
qualities are formed and character and conduct take their final
shape. "It is the critical period of life and the good or
evil habits now acquired remain until the end."
With the arrival of manhood there should be altruism which is
the quality that organised society is built upon, and as Martial
said long ago men should be able "To look on death with
placid eye, And neither fear nor wish to die."
"With the neurasthenic and hypochondriac it is quite the
opposite. "To both a morbid fear of death is ever present,
although usually not admitted, perhaps not even realised. This
obsession colours the entire outlook on life."
Most children develop into mature adults with courage and wisdom
but neurasthenics and hypochondriacs remain childlike, egoistic,
and self-centered, and they may be specious, plausible, and good
at making excuses.
If the minds of these patients is deeply probed they can be found
to have had all healthy inclinations starved and withered, and
to be like unweeded gardens "in which envy, hatred, malice,
and spite have been allowed to flourish", and they are so
self-absorbed that there is no room for outside interests.
These patients have "no kindliness of heart, no love of
country" and no generosities, and if they have any friends
at all they have no real affection for them. They vegetate in
selfishness and are usually moral and physical cowards. "Although
history for him has no meaning, and literature no existence,
and ignorant of his own ignorance, and most ignorant of what
he's most assured, yet he has very decided opinions, and is good
at making a platitude plausible by making it pompous, but he
never really thinks; he only thinks he thinks."
In vengeance for this nature might bring about what is politely
called a nervous breakdown, and the patient may whine that fate
has been unkind and that he has inherited weak nerves from his
parents or race. He may acquire a thorough knowledge of the latest
pseudo-scientific jargon but he cannot be persuaded to understand
"that his condition is the logical outcome of his wretched
scheme of existence, that having graduated in the school of selfishness,
he has simply educated and qualified himself for the misery which
now knocks at his door. Nature does not return good for evil;
she gives blow for blow."
The only hope for this type of person is to take up religion,
purge their souls, read the New Testament, pray to God, admit
to the sins of their wretched lives, and to start working to
improve their character.
Otherwise trying to convince these patients that their health
concerns are unfounded is like trying to reason with an ass.
The conclusion to be deduced is that the conditions of neurasthenia
and hypochondria are "the result of a process of wrong thinking,
wrong living, and wrong feeling."

Reference: The Modern Family Doctor (1928) p.157-158.

Alexander
Leeper's life and achievements

Alexander
Leeper

Alexander Leeper
has been described as having "massive hypochondria".
He kept extensive diaries in which he recorded everything about
his life and his health.

The achievements of Alexander Leeper are too numerous to be
comprehensively covered in a brief essay but I will describe
some of them.
He showed signs of brilliance from the age of 5 and was first
educated by his father at home and then sent to private schools.
At the age of 13 he topped his class in Classics, French, and
Scripture.
He later sat for and passed an entrance exam for the Indian Civil
Service, but he did not pursue that course probably because he
would have been rejected on the grounds of his poor health.
In 1865 he won a scholarship to study at Trinity College Dublin
(University of Dublin), where he completed a degree in Classics.

In 1871 R.T. Tyrrell, professor of Greek, described him as
the best viva voce translator that he had ever met, and Arthur
Palmer, professor of Latin, described him as the best classic
he had ever examined and believed that he would eventually come
to be regarded as one of the most distinguished scholars produced
by the University of Dublin in modern times. The professor of
Greek at Queen's University in Galway praised his special aptitude
as a teacher.
In 1872 he sat for an open scholarship to St. John's college
of Oxford University, and was granted a special exhibition of
100 pounds a year for 5 years which was the equivalent value
of the scholarship. In 1874 he gained a "first" in
Classical Moderations.
In Australia he became the Second Master of Melbourne Grammar
School, where he was also Senior Master of Classics, and he established
the school library, museum, and newspaper.
He was also appointed principal of Trinity College Melbourne,
and later changed the title to Warden, and developed the college
as a role model for other colleges associated with the Melbourne
University.
He was on the Council of the Melbourne University where he recommended
reforms which were implemented, and he was on the state Council
of Public Education.
In 1880 he delivered the main speech, about university colleges,
at the Social Sciences Congress, which was a by-product of an
International Exhibition.
He was one of the Trustees of the Public Library, Museums, and
National Gallery from the 1880's, and was president from the
1920's until his retirement.
In 1896 Alexander Leeper drew up the draft constitution for the
Library Association of Australasia and became its new chairman
and delivered speeches at its Biennial Conferences.
He "was a lover of books and a firm believer in the educational
influence of the Public library", and he suggested that
there should be a closer relationship between libraries and educational
institutions. He insisted on the need for administrative ability
in librarians, and recommended that "Universities should
honour librarians more, giving them status as professors."
In 1908 he represented the Diocese of Melbourne at the Pan-Anglican
Congress which was held in London, and which was attended by
200 bishops. He was also chairman of the Central Church League,
and a lay canon at St. Paul's Cathedral.
He was involved in the production of plays and acted in some
of them, and was the director of a play called The Wasps by Aristophanes
which was presented by the combined colleges as the jubilee production
of the Melbourne University. He also represented the Melbourne
Shakespeare Society while in the U.K.
He was president of the Classical Association of Victoria which
had 300 members, which made it the largest Classical Association
in the British Empire.
He had many famous, wealthy, and influential friends, and for
a short time he was a member of the Melbourne Club and was involved
with the Navy League.
He traveled widely throughout the United Kingdom, Europe, the
Middle East, Norway, the United States, Australia, and New Zealand,
and he attended meetings of the Australian Institute of International
Affairs.
He was also a leader of patriotic causes, especially during World
War 1 when he argued against Home Rule for Ireland, in favour
of retaining it within the British Empire.
He also contributed to many charities especially the Society
to Assist Persons of Education, and he visited Old Colonists
Homes and was acquainted with Stanley Greg Smith who was secretary
of the Charity Organisation Society, and he distributed their
tickets to the needy.

Reference: Doubts and Certainties A Life of Alexander Leeper
(1997).

Le Malade
Au Petit Papier
(The Malady of the Little Piece of Paper)

"Axel Munthe, describing his patients at his practice in
the Avenue de Villiers, says they would produce from their pockets
little pieces of paper and read out an interminable list of symptoms
and complaints - le malade au petit papier, as Charcot used to
call it".
From: Hysteria, Hypnosis & Healing: the work of J.M. Charcot
(1971) p. 56

After many
years of consulting physicians and of receiving various treatments,
all of which failed, and after seeking explanations for their
symptoms and not being given any, some 19th Century patients
methodically prepared detailed written descriptions of their
symptoms in an attempt to assist the doctor in making an accurate
diagnosis so that an effective remedy could be determined.
Such written accounts were referred to as 'le petit papier' (the
little piece of paper) and have since been used for diagnosing
hypochondria 'le malade au petit papier' on the basis of a misinterpretation
that they represented a morbid and unnecessary interest in health.
M.B.

The confused facial
expression of a doctor talking to a hypochondriac as depicted
in The Marshall Cavendish Encyclopedia of Family Health
(1988) p.772. (The patient has a considerable forward curve in
his upper spine and appears to be complaining about shoulder
pain which is often caused by sideways curvature of the spine.This
is a common form of postural pain where there is usually no x-ray
evidence of injury or disease.)

Doctors often shrug their shoulders
and present a facial expression of confusion and uncertainty
when dealing with patients who have the symptoms of hypochondria.
They also often ask for more detailed information about the severity
of symptoms, when they occur, what factors aggravate the symptoms
and what relieves them. Many patients write those details down
on paper so that they do not forget to mention them at the next
consultation.
They assume that the doctor is giving their condition serious
consideration. M.B.

The hypochondriac
..."He constantly seeks medical aid and undergoes any treatment
recommended; he is a thoroughly good patient. Any new treatment
suits him, but never does any good; nevertheless he comes back
to his doctor to whom he is usually faithful . . . He is incurable,
but should be taken care of and humoured by doctors, or he may
fall into the hands of quacks and be fleeced."
From: The Common Neuroses 2nd Edition (1937) p.60

"Letters
and autobiographies from earlier centuries reveal deep preoccupation
with matters of health and with attempts to plumb the sources
of sickness".
In fact "stethoscopes, ophthalmoscopes, and other gadgetry
were not introduced till after 1800" so doctors had no instruments
to aid in diagnosis, and, it was considered undignified to do
physical examinations by touching or exposing the patients body,
so the patients description of symptoms was the primary means
of determining the cause of disease.
"This was achieved through the sick person relating his
'history': when and how the complaint had started, what might
have precipitated it, the characteristic pains and symptoms,
and whether it was new or recurrent. The patient would also recite
the main features of his lifestyle - eating and sleeping habits,
bowel motions, details of emotional upsets, and so forth".
Treatment was usually only a matter of managing the disease with
rather ineffectual drugs and the placebo affect.
Reference: The Cambridge Illustrated History of Medicine
(1996) p. 96-97

"George
Cheyne, a well-known eighteenth century physician, considered
that one-third of his patients suffered from hypochondriasis,
in those days an all embracing term, and in 1807 Trotter was
of the opinion that it was two-thirds (Singer and Underwood)
Hypochondria is one of the most dreaded diseases in medical practice".
From: Health, Sickness, and Society (1976) p. 410 &
774.

Since the
influence of emotions on body functions has been recognised doctors
have been less confused by many syndromes. "Although there
are no over-all reliable statistics to support the following
claim, many outstanding internists have estimated that as many
as 50 per cent to 60% per cent of the patients whom they see
suffer primarily from emotional disturbances." "This
observation has tended to cut down the number of fruitless laboratory
examinations" and the previous tendency to blame the symptoms
on some minor physical defect. It has also decreased the tendency
to overtreat the illnesses where all too often the procedure
had very serious damaging effects on the patient's life.
In fact these practical considerations were more important to
the doctor than the principles of psychiatry.
Reference: The Specialties In General Practice (1951)
p.710.

According
to the above quote, the idea that some syndromes have an emotional
basis is just medical opinion which has no statistical or scientific
basis, and is accepted primarily because it is convenient for
the practical administration of confusing illnesses. M.B.

Book Details And Costs

The Health Biographies Of Alexander
Leeper, Robert Louis Stevenson, And Fanny Stevenson

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